Giant cell tumor of soft tissue: FNA cytopathology of 4 cases, review of the literature, and comparison with giant cell tumor of bone

Abstract

Background The cytopathology of a giant cell tumor of soft tissue (GCT‐ST), a fibrohistiocytic neoplasm distinct from other giant cell–rich soft tissue tumors, is rarely reported. The authors report their experience with a series of 4 GCT‐ST fine‐needle aspiration (FNA) biopsy cases and compare them with a set from giant cell tumors of bone (GCTBs). Methods The authors' cytopathology files were searched for GCT‐ST examples with histopathologic confirmation. FNA biopsy smears were performed and examined with standard techniques. Results Four cases of GCT‐ST presenting as a primary soft tissue mass from 4 patients (3 males and 1 female; age range, 28‐75 years, mean age, 53 years) were retrieved. FNA sites included the anterior tibia, buttock, shoulder, and upper back. Three cases were interpreted as suspicious for sarcoma radiographically. The specific diagnoses were atypical giant cell tumor of tendon sheath, suspicious for GCT‐ST, atypical myxoid lesion with giant cells, and benign with osteoclast‐like giant cells (OLGCs). No case was interpreted as malignant. Aspirates consisted of mononuclear polygonal cells, spindled fibroblast cell clusters, and large OLGCs to the near exclusion of other cell types. OLGCs possessed 10 or more nuclei per cell. A comparison with GCTB aspirates and single case reports from the literature showed comparable cytomorphology. Conclusions GCT‐ST FNA smears mimic those of GCTBs containing a limited population of uniform spindle cell clusters, single dispersed polygonal cells, and cytologically banal OLGCs. GCT‐ST should be considered in the differential diagnosis of aspirates containing numerous osteoclast‐like giant cells.

Cytomorphologic panorama of giant cell tumour of tendon sheath

“…Hence, it is important to differentiate these giant cell rich lesions from GCTTS as their treatment strategies are different. The cytomorphological features of various giant cell rich lesions considered as differentials of GCTTS such as giant cell tumour of bone, 7 chondroblastoma, 10 giant cell tumour of soft tissue, 11 aneurysmal bone cyst, 12 giant cell reparative granuloma, 5 rheumatoid nodule, 5 hemosiderotic synovitis, 5 and osteosarcoma 13 are summarised in Table 4 with emphasis on features differentiating these lesions from GCTTS.…”

Giant Cell Tumor of Soft Tissue—A Rare Cause of Mass in the Liver: A Case Report

“…The possibility of recurrence and metastasis is extremely low, with a local recurrence rate of 10%–15% ( 5 ). Metastasis only occurs in extremely rare cases, mainly in the lungs ( 6 ). As tumor-related death appears to be extremely rare, no clinicopathological variables that potentially predict metastasis have been discovered ( 7 ).…”

“…Tumors are usually well-circumscribed and have abundant blood vessels in the stroma, associated with common hemorrhage, hemosiderin deposition, and accumulation of foam cells ( 13 ). Malignant GCT-ST is very rare, characterized by nuclear atypia, pleomorphism, and high mitotic activity of monocytes ( 5 , 6 ). The term “malignant giant cell tumor of soft parts” should be restricted to histologically high-grade lesions.…”

Approach to Fine Needle Aspiration of Giant Cell-rich Tumors of Soft Tissue

“…79 Smears may be hyper-to hypocellular and composed of mononuclear polygonal cells, spindle cells, and numerous osteoclast-like giant cells. 80,81 These giant cells are often scattered singly, but may be seen near or within clusters of spindle cells (Fig. 3H).…”